Longitudinal Assessment of Psychological Distress and Coping Strategies in Animal Bite Victims Undergoing Rabies Post-Exposure Prophylaxis

Animal bites, especially those from dogs, are a significant public health concern, leading to physical injuries and psychological distress. Rabies, a fatal zoonotic disease transmitted through dog bites, can be prevented by effective post-exposure prophylaxis (PEP). The psychological impact, including anxiety and post-traumatic stress, is often neglected. The authors of the present study assessed psychological distress and coping responses among animal bite victims undergoing rabies PEP at multiple time points (days 0, 3, 7, and 28), using validated psychological scales to examine the influence of demographic and bite-related factors. A prospective, observational study was conducted at a tertiary care anti-rabies clinic in Northern India. Participants (≥12 years of age) with Category II or III animal bites were included. Data were collected through sociodemographic questionnaires and psychological assessments (State-Trait Anxiety Inventory, Impact of Event Scale-Revised [IES-R], Depression, Anxiety, Stress Scale [DASS-21], and Brief COPE). The sample size was 100 participants, accounting for a 20% nonresponse rate. Moderate to high anxiety levels were observed. Psychological distress, as measured via IES-R and DASS-21, decreased significantly over 28 days. Bite severity, age, and socioeconomic status influenced distress levels and coping strategies. Severe Category III bites were associated with higher anxiety and stress. The present study highlights the psychological burden of animal bites during rabies PEP, particularly severe dog bites. Psychological distress, including anxiety, post-traumatic stress disorder, and depression, improved over time, emphasizing the need for integrated psychological support in rabies PEP protocols, especially in resource-limited settings.